Individual
GEOFFREY M MILLICAN
Active
Individual
GEOFFREY M MILLICAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
M3024
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-4584500
INDIVIDUAL TAX ID
TX
01
—
M3024
TEXAS LICENSE NUMBER
TX
Enumeration date
08/30/2006
Last updated
05/06/2013
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